Perez v. Astrue

• Decision Date: 03 July 2012
• Docket Number: No. 11 CV 03153.,11 CV 03153.
• Citation: 881 F.Supp.2d 916
• Parties: Juanita D. PEREZ, Plaintiff, v. Michael J. ASTRUE, Commissioner of Social Security, Defendant.
• Court: U.S. District Court — Northern District of Illinois

881 F.Supp.2d 916

Juanita D. PEREZ, Plaintiff,

v.Michael J. ASTRUE, Commissioner of Social Security, Defendant.

No. 11 CV 03153.

United States District Court,

N.D. Illinois,

Eastern Division.

July 3, 2012.

Frederick J. Daley, Jr., Daley, Debofsky & Bryant, Chicago, IL, for Plaintiff.

Kurt N. Lindland, United States Attorney's Office, Chicago, IL, for Defendant.

MEMORANDUM OPINION AND ORDER

JEFFREY COLE, United States Magistrate Judge.

The plaintiff, Juanita Perez, seeks judicial review of the final decision of the Commissioner (“Commissioner”) of the Social Security Administration denying her applications for Disability Insurance Benefits (“DIB”) and Supplemental Security Income (“SSI”) under Title II and Title XVI of the Social Security Act (“Act”). 42 U.S.C. §§ 423(d)(2); 1382c. Ms. Perez asks the court to reverse and remand the Commissioner's decision, while the Commissioner seeks an order affirming the decision.

I.PROCEDURAL HISTORY

On December 10, 2007, Ms. Perez applied for DIB and SSI alleging that she had been disabled since March 9, 2007. (Administrative Record (“R.”) 143) ¹. Her application was denied initially on March 6, 2008, and upon reconsideration on August 18, 2008. An Administrative Law Judge (“ALJ”) convened a hearing on November 12, 2009, at which Ms. Perez, represented by counsel, appeared and testified. In addition, Grace Gianforte, an impartial vocational expert (“VE”), also testified. On December 4, 2009, the ALJ issued a decision finding that Ms. Perez was not disabled.

This became the final decision of the Commissioner when the Appeals Council denied Ms. Perez's request for review on March 8, 2011 (R. 3). On May 11, 2011, Ms. Perez appealed that decision to the federal district court under 42 U.S.C. § 405(g), and the parties have consented to the jurisdiction of a magistrate judge pursuant to 28 U.S.C. § 636(c).

II.EVIDENCE OF RECORD

Ms. Perez was born on November 14, 1956, making her fifty-years old on her alleged onset date and fifty-three years old at the time of the ALJ's decision (R. 143). At the time of her administrative hearing, she was approximately 5' 1? and 236 pounds (R. 34). Ms. Perez is married with an adult son (R. 143, 33). She also has a daughter, who, according to multiple treatment notes, is one of the primary sources of her unhappiness. (See R. 273–74, 953–977). At the time of her application for SSI, her husband was gainfully employed with METRA making approximately six thousand dollars a month. (R. 145).

A.Vocational Evidence

Ms. Perez has an eleventh-grade education, and acquired her GED in June 2006. (R. 35, 227). From 1994 to 1995 Ms. Perez worked for 3HP Investments, Inc., in an unknown capacity (R. 157–158). From 1996 until 2004 she worked for Parko Foods, LLC., in various capacities primarily as a lead label maker. (R. 68–69, 155–157, 211). Starting in late 2004, she worked as patient services representative for Pronger–Smith, Id., until she was fired from that position in March, 2007 because, “[t]he team leader and I didn't get along, so she filled out a bad report on me.” (R. 36). She has not worked since although she has been looking for work. (R. 36).

B.Medical Evidence

1.Mental Health

On January 2, 2007, Ms. Perez saw psychiatrist Dr. Jody Reed. Dr. Reed noted: sadness, tearfulness, crying, helplessness, hopelessness, eight-pound weight loss, no precipitants, no previous episodes, anxiety and worrying—constantly worries about everything, is “SOB”, no panics, and difficulty with memory and attention. (R. 265). Her “current” medications were amitriptyline, Paxil, and Xanax. Ms. Perez denied taking other medication in the past. Dr. Reed diagnoses her with Major Depression, severe, recurrent. He differed an Axis II diagnosis and for Axis IV he listed interpersonal. He determined a Global Assessment of Functioning (“GAF”) score of 45–50. Dr. Reed proposed the following treatment plan: discontinue amitriptyline and Paxil, prescribe Cymbalta, psychological and neurological testing, therapy with “Anna”, and a follow up in two weeks.

Three days later, on January 5, 2007, Ms. Perez met with therapist Anna Schiff. (R. 977). She denied any history of depression, but admitted seeing a psychologist “a long time ago.” She reported some problems at work related to a difficult co-worker. The resulting treatment plan called for weekly therapy sessions with Dr. Reed providing medication management. There are no other treatment/progress notes from Dr. Reed's practice until over a year later in November 2008.

Dr. Reed completed a Psychiatric Report for DDS on July 23, 2008. (R. 272–75). Under General Observations, he noted: “Normal posture and gait. Normal hygiene and at times can have decreased psychomotor activity. Normal clothing.” (R. 273). He noted, “Over the past few years, she has been having mood difficulties more related to interpersonal conflicts within her family. She has been in treatment and shown improvement.” (R. 273). He wrote, “She is able to function without assistance,” (R. 273), and she has a “[n]ormal level of interest in various activities”, but she has a “[s]trained relationship with her husband and child, which seems to serve as a significant stressor, which worsens her mood.” (R. 274).

Dr. Reed described her mood and affect as within normal limits, although, “at times she can become restricted and tearful.” (R. 274). Her speech was normal, her thought process logical and sequential with no hallucinations of delusion, and her orientation was normal and intact. (R. 274). Her abstract thinking was normal with no concrete thinking, her ability to note similarities and differences was normal, and her judgment was good. (R. 275).

Less than a month after the above Psychiatric Report, on August 11, Dr. Reed submitted another report to DDS. (R. 673). It reiterates a diagnosis of major depression and indicates treatment with medication and individual psychotherapy with a “Marginal Response.” Id. Also noted is “Significant impairment in mood energy, interest, hopelessness.” Id. Nonetheless, Dr. Reed indicated Ms. Perez, should have the ability to understand, carry out, and remember instructions as well as respond appropriately to supervision, co-workers and customary work pressures. Id.

Just seven days layer, on August 18, 2008, Dr. Reed submitted a completed Mental Impairment Questionnaire. (R. 696–699). For the first time, in addition to depression, he diagnosed her as Dependent Personality Disorder and Avoidant Personality Disorder and assessed a GAF score of 50–55. Id. On the form Dr. Reed checked off a multitude of symptoms. He listed her medications (Seroquel, Lexapro, Cymbalta), and indicated they did not cause any side-effects that might impact her ability to work. Id. Despite characterizing her prognosis as “Guarded,” he indicated her impairment has neither lasted nor could be expected to last at least twelve months. Id. He checked that her mental impairment would result in her absence from work more than three times a month. Id.

Dr. Reed opined Ms. Perez had no useful ability to do work related activities on a day-to-day basis in a competitive work setting, (R. 697), explaining, “Her diagnosis of Depression and Personality Disorder make her unable to function. Severe impairment in Mood, Cognition, Affect, and Sleep.” (R. 699). He went on to indicate extreme difficulties in maintaining social functioning, constant deficiencies of concentration,persistence, and pace resulting in a failure to complete tasks in a timely manner, and repeated—three or more—episodes of deterioration or decompensation in work or work-like settings. (R. 699). However, despite these assessments of crippling and pervasive dysfunction, Dr. Reed indicated that she had no restriction of activities of daily living. Id.

Meanwhile, at the Agency's request, two Psychiatric Review Techniques were completed by consultative psychologists. (R. 513–525, 674–686). Both psychologists concluded Ms. Perez suffered from an Affective Disorder, but that her impairment was not severe. (R. 513, 674). Both found she had only mild restrictions of activities of daily living and mild difficulties in maintaining concentration, persistence, and pace. (R. 523, 684). Neither found any evidence of any episodes of decompensation. Both also indicated there was no evidence that Ms. Perez's depression caused more than a minimal limitation of ability to do any basic work activity. (R. 524, 685).

Dr. Reed's treatment notes begin again on November 21, 2008, when Dr. Reed noted Ms. Perez continued to have conflicts with her daughter. (R. 965). A mental status exam/assessment (“MSE”) was entirely normal. On February 2, 2009, Ms. Perez indicated trouble sleeping and low energy levels. She said her overall mood was bad. Her MSE, however, was within normal limits.

On March 16, 2009, Ms. Perez reported she was still having conflicts with her daughter. She was still having trouble sleeping and her energy level was low. Her MSE was unremarkable noting normal mood and attention. On March 30, 2009, Ms. Perez reported she was doing better and sleeping well. (R. 959.) Dr. Reed noted an improvement in appetite, attention and concentration. Her MSE was again within normal limits. On April 13, 2009, improvements in appetite, attention, and concentration were noted. Her MSE was still within normal limits.

On June, 15, 2009, Ms. Perez's appetite, attention, and concentration continued to improve. (R. 955). Her therapist note her condition was stable and that she reported having fewer conflicts with her daughter. Her MSE was normal. On July 11, 2009, Ms. Perez although still frustrated with her daughter, indicated she was doing well on meds, she was sleeping well—without nightmares, and was taking care of herself including, going to the gym. Her mood was noted as sad, but her MSE was otherwise unremarkable. On July 17, 2009 Ms. Perez was still upset with her daughter. (R. 973). She also reported having nightmares....